Reduce the pay of doctors and NHS managers by 10 per cent. NHS pay rocketed in the middle years of this decade, far above the average rate of pay growth in the economy. NHS pay rises are already falling as the service returns to sanity, but not yet far enough. Saving: £1.3 billion.

End inappropriate defence projects. Several projects (the future carriers, Eurofighter Tranche 3b, A400M and Nimrod MRA4) do not contribute to the UK’s modern defence requirements. Saving: £2.7 billion.

Abolish the Regional Development Agencies and the regional assemblies. Saving: £1.6bn pa

But alarmingly, the Reform cuts don't go far enough. In Tyler's view, we need to find at least another £20bn pa. And a gap of that size will require the kind of emergency surgery we haven't experienced in years.

Which brings us to an issue that even true blue fiscal conservatives disagree about.

To bridge our cuts gap, we have two broad options.

First, we could simply starve the beast - ie implement across the board budget cuts driven by our overall savings target, rather than any specific central programme decisions. That has the advantage of putting the onus on spending departments/agencies to decide how best to make savings, the idea being they are closer to the sharp-end so can make more informed choices.

Unfortunately, the beast has never shown itself particularly adept at making sensible choices, as we saw with the ludicrous Gershon "efficiency cuts". It's quite likely, for example, that the healthcare beast would make savings by simply cutting down on the treatment offered to patients (aka voters).

The alternative approach is the comprehensive programme review process apparently followed in Canada, and advocated by Andrew Haldenby - the very excellent head of the very excellent Reform - himself. As he puts it:

"The wrong course of action would be the kind of panicky, unplanned cuts that we have seen in Britain many times before. This is exactly what people in the public sector are expecting: a crude reduction in their overall budget, in the form of an order from on high to cut spending by a certain arbitrary percentage...

...however appealing it sounds, this would be the wrong approach. Faced with an overall cut in their budget, public-sector leaders will tend to reduce their wage bill by cutting back on higher salaries – getting rid of the most experienced and capable staff. They will also reduce the number of administrators – firing secretaries, for example – but that just forces other staff to waste time on administration. In fact, this kind of approach would make public services less efficient – which is why it hasn't worked in the past."

Now, we do have sympathy with Haldenby's point. It would be far preferable to implement cuts that are directly related to specific policy choices (like the abolition of the Regional Development Agencies). If we can do that, we should.

But unfortunately we may not have time to decide all that: the markets are expecting quick action following the election. And if the 60s and 70s taught us anything it was that new governments need to get on the front fiscal foot quickly. Like, in the first budget quickly.

Cam and Osborne need to deliver a Big £50bn plus Cut straight off the bat next June. It is essential they are seen to grip the problem.

All well and good if they've already worked out £50bn's worth of specific programmes to ditch. But judging from what we've heard so far, we doubt that they will have.

In the circs, the gap will simply have to be filled by blanket cuts.

Of course, Cam and Oz also need to do something else, just as important.

Because any fool can cut public spending. The important longer term question is having made the cuts, how do you then get the public services to perform?

Which is why Cam needs to be much bolder in public service reform.

School vouchers, competing social health insurers, elected sheriffs... we all know the score by now. Post-cuts they will be more important than ever. They offer the only way we can hope to make less go further.

Come on Cam.

You know you are going to win a crushing election victory. But you surely also know you are inheriting a world of pain.

On the back of the biggest spending cuts Britain has ever experienced, the only way you will be able to offer genuine hope is by announcing that reform package you stuffed somewhere in the depths of your desk.

And if you've forgotten where it is, may we suggest you give Mr Haldenby a buzz?

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BOM the book now available

Drawing on six years of blogging government waste, this book shows how we spend far more than we need on our public services. It sets out the facts and explores the underlying issues. Just why does government spend so much and deliver such second rate service? Why do we put up with it? And what are the alternatives?

ABOUT BOM

Despite all the talk of cuts, government still consumes nearly half our national income. Yet many tens of billions of its spending is wasted, with taxpayers made to pick up the tab for a depressing array of overpriced sub-standard services. This is money we can no longer afford, and our National Debt is already at danger level.

If we're to avoid further decades of stagnation and austerity we urgently need to find another way. Exposing and understanding the wastefulness of government is a necessary step in the right direction.